https://orcid.org/0000-0003-0995-4372
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Abstract
Background
Nail psoriasis (NP) is common and of high importance in patients with psoriasis. Complete resolution of NP at week 24‒26 is an unambiguous nail outcome accessible for indirect treatment comparison of biologics.
Objective
To evaluate the comparative efficacy of approved biologics in achieving complete resolution of NP at week 24‒26.
Methods
A network meta-analysis (NMA) was conducted to indirectly compare the efficacy of six biologics in achieving complete resolution of NP at week 24‒26 in patients with moderate-to-severe psoriasis and concomitant NP. Complete resolution of NP was defined as a score of zero on the Nail Psoriasis Severity Index (NAPSI), modified NAPSI (mNAPSI) or Physician’s Global Assessment of Fingernails (PGA-F).
Results
The probability of achieving complete resolution of NP was highest for ixekizumab (46.5%; 95% credibility interval [CrI] 35.1‒58.0; Surface Under the Cumulative RAnking curve [SUCRA] 97%), followed by brodalumab (37.0%; 17.0‒61.0; 79%), adalimumab (28.3%; 24.4‒32.4; 62%), guselkumab (27.7%; 21.1‒35.1; 58%), ustekinumab (20.8%; 10.2‒35.2; 37%), and infliximab (0.8%; 0.0‒8.9; 17%).
Conclusion
In patients with moderate-to-severe psoriasis and concomitant NP, ixekizumab has the greatest likelihood among approved biologics of achieving complete resolution of NP at week 24‒26. Findings should be interpreted carefully because of inherent study limitations.
Acknowledgments
The authors would like to acknowledge Greg Plosker and Karen Goa (Rx Communications, Mold, UK) for medical writing assistance with the presentation of this manuscript.
Disclosure statement
Professor Reich has served as advisor and/or paid speaker for and/or participated in clinical trials sponsored by Abbvie, Affibody, Almirall, Amgen, Avillion, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Centocor, Covagen, Dermira, Forward Pharma, Fresenius Medical Care, Galapagos, GlaxoSmithKline, Janssen-Cilag, Kyowa Kirin, Leo, Eli Lilly and Company, Medac, Merck Sharp & Dohme, Novartis, Miltenyi Biotec, Ocean Pharma, Pfizer, Regeneron, Samsung Bioepis, Sanofi, Sun Pharma, Takeda, UCB, Valeant, Xenoport. Professor Conrad has served as scientific adviser and/or clinical study investigator and/or paid speaker for AbbVie, Actelion, Amgen, BMS, Celgene, Galderma, Incyte, Janssen, LEO Pharma, Eli Lilly and Company, MSD, Novartis, Pfizer, Samsung, and UCB. Professor L. E. Kristensen has received grant/research support from UCB, Biogen, Janssen pharmaceuticals, and Novartis; Speakers bureau from Pfizer, AbbVie, Amgen, UCB, Bristol-Myers Squibb, Biogen, MSD, Novartis, Eli Lilly and Company, and Janssen pharmaceuticals. Dr S. D. Smith has received honorariums for serving on industry advisory boards and/or consultancy, teaching, and education activities for Janssen Cilag, Eli Lilly and Company, Novartis, MSD, Abbvie, Sanofi Genzyme, Pfizer, Leo Pharma, Amgen, Biogen, UCB, and BMS. Dr S. D. Dr Smith has also been an investigator of clinical trials sponsored by Eli Lilly and Company, BMS, UCB, Novartis, Abbvie, Sanofi Genzyme, and Regeneron, and is co-editor of the journal Opinions and Progress in Cosmetic Dermatology. Pr L. Puig has perceived consultancy/speaker’s honoraria from and/or participated in clinical trials sponsored by Abbvie, Almirall, Amgen, Baxalta, Biogen, Boehringer Ingelheim, Celgene, Gebro, Janssen, JS BIOCAD, Leo-Pharma, Eli Lilly and Company, Merck-Serono, MSD, Mylan, Novartis, Pfizer, Regeneron, Roche, Sandoz, Samsung-Bioepis, Sanofi, and UCB. Dr P. Rich has acted as principal investigator of clinical trials sponsored by Abbvie, Arcutis, Bristol-Myers Squibb, Dermavant, Eli Lilly and Company, Novartis, Sun Pharma, and UCB, and has participated on a Leo advisory board. C. Sapin, T. Holzkaemper, U. Koppelhus, and C. Schuster are employees of Eli Lilly and Company, Indianapolis, IN, USA.